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Guest Post: Jonathon Erlen’s Dissertation Abstracts

Editor’s Note: Readers of Social History of Alcohol and Drugs, the Alcohol and Drugs History Society’s journal, are aware of Jonathon Erlen‘s ongoing bibliography of recent dissertations related to alcohol, tobacco, and other drugs. Until now, Dr. Erlen, the History of Medicine Librarian at the University of Pittsburgh, curated and published his dissertation lists in the print edition of the journal. In the spirit of rapid dissemination and open access, the Alcohol and Drugs History Society has moved the publication of Erlen’s bibliography to the blog. Below, we highlight a few of the most intriguing entries and provide links to pdfs of Erlen’s selections from the monthly ProQuest index. These entries were released by ProQuest in the summer and fall of 2013.

Abstract: This dissertation uses proprietary drug screening data, illicit drug prices from the DEA STRIDE database, and national and local macroeconomic variables to measure the price responsiveness and treatment effectiveness of methadone maintenance therapy (MMT) on patients in a voluntary, methadone-treatment program in a rural Alabama county. This is done using conventional, myopic, and rational models of demand. The demand for illicit drugs is found to be sensitive to national drug prices as estimated from the Drug Enforcement Agency’s System to Retrieve Drug Evidence (STRIDE), length of time in treatment, previous consumption, and the local unemployment rate. An important innovation in this paper is the use of temperature data from coca-plant-growing regions as an instrument for the cocaine prices taken from the DEA STRIDE database. Use of this instrument yields estimation results more in line with the predictions one obtains from economic theory. The estimation results imply that methadone maintenance therapy is a substitute for all illicit drugs under analysis. The implied price elasticity of cocaine use by MMT patients ranges from -0.0003 to -0.01284 and the unemployment elasticity of cocaine use is -0.00385.

The Sober Self: Discourse and identity of recovering alcoholics in the Western Highlands of Guatemala

Abstract: In this dissertation, I focus on how political, economic, and cultural histories influence experiences of alcohol abuse and alcoholism recovery amongst indigenous community members in Panajachel, Guatemala. My research goals were twofold: 1) to document and understand the political, economic, and sociocultural processes that impact the prevalence of alcoholism, treatment options and experiences, and sobriety attempts among Panajachelense problem drinkers and 2) to use this information to contribute to ongoing efforts to expand and improve mental health outreach to problem drinkers in the area. I combine ethnographic and epidemiological methodologies within a critically engaged phenomenological framework to document the enduring influence of discriminatory discourses on the lived experience of alcohol addiction and recovery in a historically oppressed population, namely the Kaqchikel Maya. Utilizing ethnographic, epidemiological, and critical discourse analysis from data derived from fifteen months of fieldwork, I argue that national historical discourses that equated indigeneity with alcoholism continue to impact perceptions of alcoholic individuals at the local level. While both men and women are affected by alcoholism, national and local discourses typically focus on male drinking. Moreover, prevalence data I collected highlight how alcoholism disproportionately affects men in Panajachel. As such, the primary focus of this dissertation is centered on male alcoholic individuals in the process of recovery. I demonstrate how the phenomenological shift from an alcoholic identity to a sober self is influenced and constructed by historical political and contemporary social and economic processes amongst the Kaqchikel Maya in Panajachel. The difficult negotiation of sobriety arises from a state of disequilibrium between the external identity of “alcoholic” and the internal experience of the “sober self.” The Sober Self is defined by a phenomenological shift in the natural attitude of the individual that radiates to those he is connected to within his lifeworld. Yet this transformation into the Sober Self is riddled with political, economic, and social barriers that define the experience of alcoholism and impede the process of recovery. Discrimination toward alcoholic individuals poses significant barriers to recovery. Additionally, available treatment models in the region do not meet the needs of the typical alcoholic Panajachelense. The notion of the Sober Self expands upon emerging anthropological literature on self-transformation based in non-Americanized therapeutic processes for sobriety. This dissertation provides one of the first detailed portraits of the experience of alcoholism and recovery in indigenous communities within the Highlands of Guatemala. It builds upon previous anthropological work on alcoholism that limited discussion to the role of the church and Alcoholics Anonymous as primary mechanisms to achieve sobriety in the region. The work presented in this dissertation is meant to highlight the need for more comprehensive treatment programs in order to address the alcohol-related health, social, and economic issues found throughout the Western Highlands of Guatemala.

Abstract: The Establecimiento Penitenciario de Mujueres de Chorrillos (commonly referred to by its previous name, Santa Monica) in Lima, Peru was built in 1952 as a reformatory to hold 300 women but by June 2012 it held over 3,500, many of them serving sentences for drug trafficking. This is the largest female prison in this Andean nation. An intersectional analysis of prisoners’ narratives collected during fieldwork conducted from 2008 to 2009 demonstrates two inter-related processes. First, inequality was produced and reproduced inside this prison through the interconnections of race, gender, class and citizenship. Prisoners’ daily lives and access to resources were constrained by the same inequalities that led to their incarceration. Multiple divisions among women mirrored national and globalized structural inequalities and citizenship in particular emerged as a dividing force. Santa Monica’s stratification system was continuously reproduced as prisoners competed for life dependent resources. Secondly, I show the ways in which women’s labor was the linchpin between the transnational cocaine commodity chain and the prison. Santa Monica transformed into a place to “dispose of” low-level workers of the transnational cocaine commodity chain. Because the majority of these workers were women, their labor became the bond between illegal cocaine and the prison. Those who worked as drug couriers and minor retailers were laboring at the riskiest and most visible jobs to police surveillance. They were arrested when they were no longer needed or once they become a threat to the day-to-day operation of trafficking drugs while the (mostly male) middle managers above them remained in the background. Women’s labor therefore created a symbiotic relationship between the prison and this chain where each side helped the other grow and expand. Once incarcerated, these women faced a hierarchy that shaped options for survival as they served their sentences.

From science to sport: A cross disciplinary examination of the justification for doping bans

Abstract: In this dissertation, I will use a cross-disciplinary approach to evaluate the ethics of doping and performance enhancement in sport. I believe such an approach will help remove many myths and assumptions about the ethics of performance-enhancing substances (PESs) that have long stalled the debate. These myths emerged due largely to scholars misunderstanding or remaining unaware of research that existed beyond their individual “silos” of expertise. Subsequently, one central question regarding the ethics of PESs remains unsatisfactorily answered: are sporting organizations justified to prohibit athletes from using PESs? This question will be at the center of my dissertation. Yet I will not offer any final conclusions about the permissibility of drugs in sport, either. Indeed, I do not believe there are any. What I will claim, instead, is that sporting communities have no necessary grounds for rejecting PESs. Yet contingent reasons may exist justifying their decision to prohibit or regulate athletes’ PES use. In order to provide appropriate context for my later claims, my first two chapters will examine the historical development of the doping attitudes from their nascent stages to the death of Knud Enemark Jensen at the 1960 Rome Olympic Games. These chapters provide the necessary context for the modern PES debate by showing how significant cultural movements such as the fascination with doping horses for gambling, muscular Christianity, temperance movements, amateurism, and notions of public health helped shape today’s anti-doping attitudes. Following, my third chapter will turn to modern PESs and the science behind them. This chapter will help establish certain facts about performance enhancement such as performance gains, mechanisms of action and health risks which are important in ethical decision making. These scientifically grounded conclusions will help dismiss many myths as well as shape subsequent evaluations of the arguments for and against prohibiting PESs. This evaluation will come in my fourth chapter, where I will thematically and critically review past literature discussing the ethics of banning PESs in sports. This review will show that little consensus exists regarding the justification for prohibiting PESs and new efforts towards understanding the ethics of PESs may be justified. In my final two chapters, I will use the cross-disciplinary evidence developed in the first half of my dissertation to establish new ways of viewing the PES debate. The first step, which I will address in chapter five, involves viewing the debate as two separate questions: what are the acceptable means for “performance enhancement” and why should sports ban “doping.” In my sixth chapter, I use the cross-disciplinary information to inform a more rational evaluation of PESs, arguing that performance enhancing substances may either improve or harm wellestablished sporting tests. This, I will argue, renders any ipso facto rejection of enhancement unwarranted if not also irrational. I end with an epilogue that cautions against hastily altering the pharmacological landscape as certain issues still remain at work. Despite such issues, I acknowledge that specific PESs may potentially improve certain sports by opening new avenues for enjoyment. Thus I do not conclude that all PESs are necessarily wrong, but that sporting organizations can justifiably choose to ban or regulate athletes’ use of such technologies principally for reasons not typically advanced in the current PES literature.